DESCRIPTION: (Applicant's Description) Pain control for cancer patients is a significant problem in health care, and under treatment of cancer pain is widespread. Lack of expertise by clinicians in assessing and managing cancer pain has been cited as an important cause of poor pain control. In the light of studies at our institution demonstrating multiple deficits in critical clinical skills on the part of students and surgery residents, the Structured Clinical Instruction Module (SCIM) has been piloted as a format for enhancing the teaching of clinical skills pertinent to the diagnosis of cancer pain in the multi-disciplinary care of the patient with cancer. The SCIM is an abbreviated course that places trainees in realistic clinical settings, including the opportunity to interact with actual patients. The current study proposes to develop and implement the SCIM for medical students with the teaching of critical clinical skills critical to the diagnosis and multi-disciplinary management of the cancer pain patient. Specific aims are: 1) to present medical students with instruction and clinical skills related to all aspects of assessment and management of the cancer pain patient including history and physical examination, implementation of standard analgesic regimen, utilization of alternate routes of analgesic administration, psycho-social factors, and communication of the diagnosis; and 2) liberal use of standardized patients for skills training, including real and simulated patients, and test the feasibility and benefit of using actual cancer patients to help educate medical students. Instruction will be given by experts in the various fields (anesthesia, oncology and nursing, behavioral medicine, social work, family medicine, medical oncology, surgical oncology, pharmacy) involved in the care of cancer patients. The effectiveness of SCIM training will be evaluated by testing all medical students with an objective structured clinical examination format within six months following the instruction program. The performance skills of the third year medical students will be compared between three groups, ie self instruction module alone, self instruction module plus SCIM module, or self instruction plus SCIM module plus home visit module.